Peripheral arterial disease (also called PAD) is a problem with blood flow in the arteries. Arteries carry blood to the muscles and organs in your body. A progressive disease that involves the hardening and narrowing of the arteries due to a gradual build-up of plaque (fatty deposits). The most common cause of narrow or blocked arteries is the buildup of fatty deposits.
Dr. Delton Farquharson, General and Vascular Surgeon, presenting at Doctors Hospital’s free monthly public Health Lecture, the Distinguished Lecture Series, explained that "Peripheral Artery Disease is very common, though under-diagnosed. Many people never experience symptoms and those who do often mistake the symptoms for something else."
Peripheral arterial disease is a form of atherosclerosis. Atherosclerosis, common in Western societies is a leading cause of death and involves almost all-major arteries of the body. Atherosclerosis can limit the ability of the narrowed arteries to increase delivery of blood and oxygen to tissues during periods of increased oxygen demand such as during exertion. Complete obstruction of an artery by a thrombus or embolus (thrombus and embolus are forms of blood clots) resulting in tissue necrosis (death of tissue).
Risk factors for PAD include Hypertension (high blood pressure), Diabetes, High Cholesterol, Smoking (tobacco and marijuana) advanced age, gender, obesity, sedentary lifestyle and family history. Speaking to a conference room, packed to capacity, Dr. Farquharson listed the symptoms to include Intermittent Claudication, a painful, aching, cramping, or tired feeling in the muscles of the leg—not in the joints. They occur regularly and predictably during physical activity but are relieved promptly by rest. The pain begins more quickly and is more severe when the person walks quickly or uphill.
After 1 to 5 minutes of rest (sitting is not necessary), the person can walk the same distance already covered.
Most commonly, the pain occurs in the calf, but it can also occur in the thigh, hip, or buttock, depending on the location of the blockage.
When this happens, the distance a person can walk without pain decreases. The blood supply to a foot is severely reduced, the foot may be cold, and the skin of the foot or leg may be dry, scaly, shiny, or cracked. Nails may not grow normally, and the hair on the limb may not grow.
Dr. Farquharson went on to explain that Rest Pain, another symptom, occurs when the artery occlusion is so critical that there is not enough blood and oxygen supply to the lower extremities, even at rest. Pain typically affects the feet, is usually severe, and occurs at night when the patient assumes a supine position (lying down, face up). Other symptoms such as numbness of the extremities, weakness and atrophy (diminished size and strength) of the calf muscle; a feeling of coldness in the legs or feet, changes in colour of the feet; hair-loss over the dorsum of the feet; thickening of the toenails and painful ulcers and/or gangrene; typically in the toes can occur. PAD is similar to heart angina, mesenteric angina (intestinal) and TIA and can also mimic heart attack and stroke.
Many of the persons attending were told that with the following lifestyle modifications they could decrease their risks:
• Smoking cessation eliminates a major risk factor for disease progression and lowers the incidences of rest pain and need for amputations
• A healthy diet can help lower blood cholesterol and other lipid levels and may help control blood pressure
• Hypertension and Diabetes control
• Supervised exercise
• Weight reduction
For more information about Peripheral Arterial Disease, contact Dr. Farquharson at 328-5420.
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